Rates and Determinants of Virologic and Immunological Response to HAART Resumption After Treatment Interruption in HIV-1 Clinical Practice
To describe CD4 and HIV RNA changes during treatment resumption (TR) after treatment interruption (TI) compared with response to first highly active antiretroviral therapy (HAART) and to investigate predictors. Using Concerted Action on SeroConversion to AIDS and Death in Europe (CASCADE) data, we i...
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| Veröffentlicht in: | Journal of acquired immune deficiency syndromes (1999) 2008-12, Vol.49 (5), p.492-498 |
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| container_issue | 5 |
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| container_title | Journal of acquired immune deficiency syndromes (1999) |
| container_volume | 49 |
| creator | TOULOUMI, Giota PANTAZIS, Nikos STIRNADEL, Heide A WALKER, A. Sarah BOUFASSA, Faroudy VANHEMS, Philippe PORTER, Kholoud |
| description | To describe CD4 and HIV RNA changes during treatment resumption (TR) after treatment interruption (TI) compared with response to first highly active antiretroviral therapy (HAART) and to investigate predictors.
Using Concerted Action on SeroConversion to AIDS and Death in Europe (CASCADE) data, we identified subjects who interrupted first HAART, not initiated during primary infection. We estimated rate of CD4 change during TR and time from TR to HIV RNA |
| doi_str_mv | 10.1097/QAI.0b013e318186ead2 |
| format | Article |
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Using Concerted Action on SeroConversion to AIDS and Death in Europe (CASCADE) data, we identified subjects who interrupted first HAART, not initiated during primary infection. We estimated rate of CD4 change during TR and time from TR to HIV RNA<500 copies per milliliter and subsequent rebound and factors associated with these outcomes.
Of 281 persons treated for median 18.4 months before interrupting, 259 resumed HAART. CD4 increases in the first 3 months on HAART were similar pre-TI and post-TI but after 3 months were significantly higher during pre-TI HAART, with median +106 and +172 cells per microliter at 3 and 18 months, respectively, during initial HAART compared with +99 and +142 cells per microliter during post-TI HAART, respectively. Subjects with lower CD4 counts at TI, aged older than 40 years, and those resuming the same HAART as their pre-TI regimen had lower CD4 increases during the first 3 months of TR. The majority (86%) of individuals reinitiating therapy achieved HIV RNA<500 copies per milliliter.
Immune reconstitution after TI is generally poorer than after first HAART, particularly for patients aged older than 40 years at TI and those with poorer immunological responses to pre-TI HAART. Reinitiation of the same HAART regimen as pre-TI also seems to have unfavorable outcomes.</description><identifier>ISSN: 1525-4135</identifier><identifier>EISSN: 1944-7884</identifier><identifier>DOI: 10.1097/QAI.0b013e318186ead2</identifier><identifier>PMID: 18989233</identifier><identifier>CODEN: JDSRET</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adolescent ; Adult ; Anti-HIV Agents - administration & dosage ; Anti-HIV Agents - therapeutic use ; Antiretroviral drugs ; Antiretroviral Therapy, Highly Active ; Biological and medical sciences ; CD4 Lymphocyte Count ; Clinical medicine ; Drug Administration Schedule ; Drug therapy ; Female ; Fundamental and applied biological sciences. Psychology ; HIV ; HIV Infections - drug therapy ; HIV Infections - immunology ; HIV Infections - virology ; HIV-1 ; Human immunodeficiency virus ; Human immunodeficiency virus 1 ; Human viral diseases ; Humans ; Immunology ; Infectious diseases ; Life Sciences ; Male ; Medical sciences ; Microbiology ; Miscellaneous ; Other ; Ribonucleic acid ; RNA ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Virology ; Young Adult</subject><ispartof>Journal of acquired immune deficiency syndromes (1999), 2008-12, Vol.49 (5), p.492-498</ispartof><rights>2009 INIST-CNRS</rights><rights>Copyright Lippincott Williams & Wilkins Dec 2008</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c403t-8510de3297384f74858d0bd7175b64f8d351b982d882da01cb5183b8654ae2923</citedby><cites>FETCH-LOGICAL-c403t-8510de3297384f74858d0bd7175b64f8d351b982d882da01cb5183b8654ae2923</cites><orcidid>0000-0003-3188-1456</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20904870$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18989233$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-00428091$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>TOULOUMI, Giota</creatorcontrib><creatorcontrib>PANTAZIS, Nikos</creatorcontrib><creatorcontrib>STIRNADEL, Heide A</creatorcontrib><creatorcontrib>WALKER, A. Sarah</creatorcontrib><creatorcontrib>BOUFASSA, Faroudy</creatorcontrib><creatorcontrib>VANHEMS, Philippe</creatorcontrib><creatorcontrib>PORTER, Kholoud</creatorcontrib><creatorcontrib>CASCADE Collaboration</creatorcontrib><title>Rates and Determinants of Virologic and Immunological Response to HAART Resumption After Treatment Interruption in HIV-1 Clinical Practice</title><title>Journal of acquired immune deficiency syndromes (1999)</title><addtitle>J Acquir Immune Defic Syndr</addtitle><description>To describe CD4 and HIV RNA changes during treatment resumption (TR) after treatment interruption (TI) compared with response to first highly active antiretroviral therapy (HAART) and to investigate predictors.
Using Concerted Action on SeroConversion to AIDS and Death in Europe (CASCADE) data, we identified subjects who interrupted first HAART, not initiated during primary infection. We estimated rate of CD4 change during TR and time from TR to HIV RNA<500 copies per milliliter and subsequent rebound and factors associated with these outcomes.
Of 281 persons treated for median 18.4 months before interrupting, 259 resumed HAART. CD4 increases in the first 3 months on HAART were similar pre-TI and post-TI but after 3 months were significantly higher during pre-TI HAART, with median +106 and +172 cells per microliter at 3 and 18 months, respectively, during initial HAART compared with +99 and +142 cells per microliter during post-TI HAART, respectively. Subjects with lower CD4 counts at TI, aged older than 40 years, and those resuming the same HAART as their pre-TI regimen had lower CD4 increases during the first 3 months of TR. The majority (86%) of individuals reinitiating therapy achieved HIV RNA<500 copies per milliliter.
Immune reconstitution after TI is generally poorer than after first HAART, particularly for patients aged older than 40 years at TI and those with poorer immunological responses to pre-TI HAART. Reinitiation of the same HAART regimen as pre-TI also seems to have unfavorable outcomes.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Anti-HIV Agents - administration & dosage</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Biological and medical sciences</subject><subject>CD4 Lymphocyte Count</subject><subject>Clinical medicine</subject><subject>Drug Administration Schedule</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>HIV</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - immunology</subject><subject>HIV Infections - virology</subject><subject>HIV-1</subject><subject>Human immunodeficiency virus</subject><subject>Human immunodeficiency virus 1</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunology</subject><subject>Infectious diseases</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Microbiology</subject><subject>Miscellaneous</subject><subject>Other</subject><subject>Ribonucleic acid</subject><subject>RNA</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. 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Sarah</au><au>BOUFASSA, Faroudy</au><au>VANHEMS, Philippe</au><au>PORTER, Kholoud</au><aucorp>CASCADE Collaboration</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rates and Determinants of Virologic and Immunological Response to HAART Resumption After Treatment Interruption in HIV-1 Clinical Practice</atitle><jtitle>Journal of acquired immune deficiency syndromes (1999)</jtitle><addtitle>J Acquir Immune Defic Syndr</addtitle><date>2008-12-15</date><risdate>2008</risdate><volume>49</volume><issue>5</issue><spage>492</spage><epage>498</epage><pages>492-498</pages><issn>1525-4135</issn><eissn>1944-7884</eissn><coden>JDSRET</coden><abstract>To describe CD4 and HIV RNA changes during treatment resumption (TR) after treatment interruption (TI) compared with response to first highly active antiretroviral therapy (HAART) and to investigate predictors.
Using Concerted Action on SeroConversion to AIDS and Death in Europe (CASCADE) data, we identified subjects who interrupted first HAART, not initiated during primary infection. We estimated rate of CD4 change during TR and time from TR to HIV RNA<500 copies per milliliter and subsequent rebound and factors associated with these outcomes.
Of 281 persons treated for median 18.4 months before interrupting, 259 resumed HAART. CD4 increases in the first 3 months on HAART were similar pre-TI and post-TI but after 3 months were significantly higher during pre-TI HAART, with median +106 and +172 cells per microliter at 3 and 18 months, respectively, during initial HAART compared with +99 and +142 cells per microliter during post-TI HAART, respectively. Subjects with lower CD4 counts at TI, aged older than 40 years, and those resuming the same HAART as their pre-TI regimen had lower CD4 increases during the first 3 months of TR. The majority (86%) of individuals reinitiating therapy achieved HIV RNA<500 copies per milliliter.
Immune reconstitution after TI is generally poorer than after first HAART, particularly for patients aged older than 40 years at TI and those with poorer immunological responses to pre-TI HAART. Reinitiation of the same HAART regimen as pre-TI also seems to have unfavorable outcomes.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>18989233</pmid><doi>10.1097/QAI.0b013e318186ead2</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-3188-1456</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of acquired immune deficiency syndromes (1999), 2008-12, Vol.49 (5), p.492-498 |
| issn | 1525-4135 1944-7884 |
| language | eng |
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| source | MEDLINE; Journals@Ovid LWW Legacy Archive; Free E- Journals; Journals@Ovid Complete |
| subjects | Adolescent Adult Anti-HIV Agents - administration & dosage Anti-HIV Agents - therapeutic use Antiretroviral drugs Antiretroviral Therapy, Highly Active Biological and medical sciences CD4 Lymphocyte Count Clinical medicine Drug Administration Schedule Drug therapy Female Fundamental and applied biological sciences. Psychology HIV HIV Infections - drug therapy HIV Infections - immunology HIV Infections - virology HIV-1 Human immunodeficiency virus Human immunodeficiency virus 1 Human viral diseases Humans Immunology Infectious diseases Life Sciences Male Medical sciences Microbiology Miscellaneous Other Ribonucleic acid RNA Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Virology Young Adult |
| title | Rates and Determinants of Virologic and Immunological Response to HAART Resumption After Treatment Interruption in HIV-1 Clinical Practice |
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